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Heart Failure (HF) - Coggle Diagram
Heart Failure (HF)
Pathophysiology (Causes)
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Functional or structural disorders that result in low cardiac output, systemic or pulmonary blockages.
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Increased left intraventricular pressure is needed to get the aortic valve to open. The heart works harder and develops an increase in the wall tension of the left ventricle.
Systolic and diastolic dysfunction: fluid overload and pressure. Increased chamber wall thickness and delay in relaxation of the chamber.
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Right ventricular dysfunction: caused by congenital heart defects, such as tetralogy of Fallot and ventricular septal defect (VSD)
Collaborative Management
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Surgeons - possible transplant in end-stage HF or mechanical devices to aid heart function such as VAD
Symptoms
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Fatigue of the legs and accessory muscles of respiration, due to inadequate CO during exercise.
Right HF: dependent edema and ascites, impaired liver function signs, anorexia with GI distress and weight loss
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Left-sided HF: Activity intolerance and signs of decreased tissue perfusion, cyanosis and signs of hypoxia, orthopnea including cough with frothy sputum as well as paroxysmal nocturnal dyspnea
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Fatigue, weakness, and mental confusion due to diminished LV output
Complications
Systolic dysfunction: resulted form a decrease in the myocardial contractility and cardiac ejection of <40%. The decrease in ejection fraction could lead to larger preload, ventricular dilation, ventricular wall tension, and ventricular preload pressure. Usually caused by fluid overload and overload of pressure. Check for left-sided heart failure.
Diastolic dysfunction: increase in wall thickness and delayed relaxation during diastolic filling while there isn't much elasticity to let it fill. Tachycardia will also shorten the filling time, thus enhancing the diastolic dysfunction.
Left sided HF: Decreased CO, Pulminary congestion which leads to impaired gas exchange and pulmonary edema
Right sided HF: Congestion of peripheral tissue, GI tract congestion, and liver congestion
Impaired gas exchange due to acute pulmonary edema,
Risk Factors
Diastolic dysfunction progresses with age, happens more with females than males, and increases in people with HTN and atrial fibrillation.
Renal failure - retention of salt and water increases vascular pressure that can increase systemic edema
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Labs/Diagnostic Tests
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Check weight: Weight gain of more than 2 lb (0.90 kg) in 24 hours or 5 lb (2.27 kg) in 1 week is a sign of worsening failure.4
TABLE 26-3 Classification of Blood Pressure in Adults (by the 2017 Guidelines of the American College of Cardiology and American Heart Association)
Blood Pressure Classification Systolic Blood Pressure (mm Hg) Diastolic Blood Pressure (mm Hg)
Normal <120 and <80
Elevated 120–129 and <80
Stage 1 hypertension 130–139 or 80–89
Stage 2 hypertension >140 or ≥90